Abstract
Managers and administrators in charge of social protection and health financing, service purchasing and provision play a crucial role in harnessing the potential advantage of prudent organization, management and purchasing of health services, thereby supporting the attainment of Universal Health Coverage. However, very little is known about the needed quantity and quality of such staff, in particular when it comes to those institutions managing mandatory health insurance schemes and purchasing services. As many health care systems in low- and middle-income countries move towards independent institutions (both purchasers and providers) there is a clear need to have good data on staff and administrative cost in different social health protection schemes as a basis for investing in the development of a cadre of health managers and administrators for such schemes. We report on a systematic literature review of human resources in health management and administration in social protection schemes and suggest some aspects in moving research, practical applications and the policy debate forward.
Highlights
The health workforce has received major policy attention over the past decade, not least by the Millennium Development Goals (MDGs) and the Sustainable Development Goals (SDGs) and universal health coverage (UHC)
We suggest some elements of developing this area of research and policy based on a narrative review of relevant studies combined with the management, consulting and field experience of all authors and outline areas of further research
A recent book by the World Bank [22] aiming to help decision makers better understand and address their workforce challenges mentions “Leadership, governance, and management weaknesses” (p. 2) and emphasizes the importance of management capacity, but does not cover the management of either health financing and purchasing entities or health facilities. This lack of coverage might be explained by fundamental differences between clinical human resources in health (HRH) and managerial and administrative HRH as part of social protection expertise, as the needs for the former are universally grounded in the bio-medical nature of human beings in terms of prevention, treatment, and rehabilitation, while the needs for the latter are shaped by very specific characteristics of a country’s health and social protection systems based on different institutional developments and societal norms and values
Summary
The health workforce has received major policy attention over the past decade, not least by the Millennium Development Goals (MDGs) and the Sustainable Development Goals (SDGs) and universal health coverage (UHC). After publication of the 2010 World Health Report on health system financing, more than 60 countries have approached WHO for technical support in moving towards universal coverage [5]. This article reviews the current knowledge about staff in health care purchasing and management of social health protection schemes in all countries irrespective of their income level. We suggest some elements of developing this area of research and policy based on a narrative review of relevant studies combined with the management, consulting and field experience of all authors and outline areas of further research
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